Recent Advances in the Economic Evidence Abroad of Early Detection and Treatment of Type 2 Diabetes：a Review from the Health Management Perspective

doi:10.12114/j.issn.1007-9572.2018.00.245

Abstract

Abstract: Diabetes has become one of the four major non-communicable diseases in various countries.Type 2 diabetes mellitus（T2DM） is the most common form of diabetes，which is found in more than 90% of diabetic patients.Comprehensive treatment and management can effectively reduce the risk of T2DM and delay its development，so such interventions should be taken as soon as possible.We defined early comprehensive interventions for T2DM patients and high-risk populations，analyzed the studies published overseas concerning economic analysis of early screening，early glycemic control，early diagnosis and treatment for complications，and early comprehensive interventions for T2DM，with a view to providing a reference for the economic studies about early diagnosis and treatment of Chinese T2DM patients as well as for the promotion of comprehensive health management of such patients.

Key words: Diabetes, type 2；Early detection and early treatment；Screening；Complication；Economic

摘要： 糖尿病已成为各国面临的四大非传染性疾病之一，其中最主要的类型是2型糖尿病，占糖尿病患者的90%以上。对其实行综合性治疗+管理的措施能够有效降低疾病的发生风险并延缓其发展进程，方便患者及早采取适当的干预措施。本文旨在对2型糖尿病早诊早治的范畴进行界定，并对国外已发表的有关2型糖尿病筛查、及早的血糖控制、并发症早诊早治、综合干预等经济学研究文献进行分析，以期为我国基于本国2型糖尿病患者的现状及实际开展的早诊早治措施的经济性研究提供参考，同时为促进患者的综合健康管理提供依据。

关键词: 糖尿病, 2型, 早诊早治, 筛查, 并发症, 经济

RAN Xuerong,WU Hongyan,WANG Long, et al. Recent Advances in the Economic Evidence Abroad of Early Detection and Treatment of Type 2 Diabetes：a Review from the Health Management Perspective　[J]. Chinese General Practice, 2018, 21(34): 4278-4282. DOI: 10.12114/j.issn.1007-9572.2018.00.245.
冉雪蓉,伍红艳,王龙等. 基于人群健康管理视角分析促进2型糖尿病早诊早治措施经济性的国外研究进展[J]. 中国全科医学, 2018, 21(34): 4278-4282. DOI: 10.12114/j.issn.1007-9572.2018.00.245.

References

［1］International Diabetes Federation.IDF Diabetes Atlas 7th Edition（2015）［EB/OL］.［2018-10-12］.https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/13-diabetes-atlas-seventh-edition.html.
［2］中华医学会糖尿病学分会.中国2型糖尿病防治指南（2013年版）［J］.中华内分泌代谢杂志，2014，30（10）：893-942.DOI：10.3760/cma.j.issn.1000-6699.
Chinese Diabetes Society.Chinese guidelines for the prevention and treatment of type 2 diabetes（2013 edition）［J］.Chinese Journal of Endocrinology and Metabolism，2014，30（10）：893-942.DOI：10.3760/cma.j.issn.1000-6699.
［3］CDC Diabetes Cost-effectiveness Study Group.The cost-effectiveness of screening for type 2 diabetes［J］.Journal of American Medical Association，1998，280（20）：1757-1763.
［4］HOERGER T J，HARRIS R，HICKS K A，et al.Screening for type 2 diabetes mellitus：a cost effectiveness analysis［J］.Annals Internal Medicine，2004，140（9）：689-699.
［5］LI R，ZHANG P，LAWRENCE B，et al.Cost-effectiveness of interventions for preventing and controlling diabetes mellitus：a systematic review［J］.Diabetes Care，2010，33（8）：1872-1894.
［6］张洁，梁明斌，何青芳，等.农村社区门诊糖尿病筛查效果与成本效果分析［J］.中国农村卫生事业管理，2015，35（1）：69-71.
ZHANG J，LIANG M B，HE Q F，et al.Cost-effectiveness analysis on diabetes screening among outpatients in rural community［J］.Chinese Rural Health Service Administration，2015，35（1）：69-71.
［7］李安乐，刘文斌，黄胜春，等.社区糖尿病筛查的成本效果探讨分析［J］.现代预防医学，2013，40（19）：3612-3614.
LI A L，LIU W B，HUANG S C，et al.Analysis of cost-effectiveness about screening among different screening models in communities in Shanghai［J］.Modern Preventive Medicine，2013，40（19）：3612-3614.
［8］NAGY B，ZSOLYOM A，NAGYJANOSI L，et al.Cost-effectiveness of a risk based secondary screening program of type 2 diabetes［J］.Diabetes/Metabolism Research & Reviews，2016，32（7）：710-729.DOI：10.1002/dmrr.2791.
［9］SCHAUFLER T M，WOLFF M.Cost effectiveness of preventive screening programmes for type 2 diabetes mellitus in Germany［J］.Applied Health Economics & Health Policy，2010，8（3）：191-202.DOI：10.2165/11532880-000000000-00000.
［10］CHAUDHARI P，VALLARINO C，LAW E H，et al.Evaluation of patients with type 2 diabetes mellitus receiving treatment during the pre-diabetes period：is early treatment associated with improved outcomes?［J］.Diabetes Research and Clinical Practice，2016，122：162-169.DOI：10.1016/j.diabres.2016.10.020.
［11］SCHWAB P，SAUNDANKAR V，BOUCHARD J，et al.Early treatment revisions by addition or switch for type 2 diabetes：impact on glycemic control，diabetic complications，and healthcare costs［J］.BMJ Open Diabetes Research and Care，2016，4（1）：1-7.DOI：10.1136/bmjdrc-2015-000099.
［12］GOODALL G，SARPONG E M，HAYES C，et al.The consequences of delaying insulin initiation in UK type 2 diabetes patients failing oral hyperglycaemic agents：a modelling study［J］.BMC Endocrine Disorders，2009，9（1）：1-9.DOI：10.1186/1472-6823-9-19.
［13］MOHAMED Q，GILLIES M C，WONG T Y.Management of diabetic retinopathy：a systematic review［J］.Journal of American Medical Association，2007，298（8）：902-916.
［14］JAVITT J C，AIELLO L P，CHIANG Y，et al.Preventive eye care in people with diabetes is cost saving to the federal government：implications for health-care reform ［J］.Diabetes Care，1994，17（8）：909-917.
［15］JAVITT J C，AIELLO L P.Cost-effectiveness of detecting and treating diabetic retinopathy［J］.Annals of Internal Medicine，1996，124（1）：164-169.
［16］VIJAN S，HOFER T P，HAYWARD R A.Cost-utility analysis of screening intervals for diabetic retinopathy in patients with type 2 diabetes mellitus［J］.Journal of American Medical Association，2000，283（7）：889-896.
［17］LUND S H，ASPELUND T，KIRBY P，et al.Individualised risk ssessment or diabetic etinopathynd optimization of screening intervals：a scientific approach to reducing healthcare costs［J］.British Journal of Ophthalmology，2016，100（5）：683-687.DOI：10.1136/bjophthalmol-2015-307341.
［18］BRECHNER R J，COWIE C C，HOWIE L J，et al.Ophthalmic examination among adults with diagnosed diabetes mellitus［J］.The Journal of the American Medical Association，1993，270（14）：1714-1718.
［19］MABERLEY D，WALKER H，KOUSHIK A，et al.Screening for diabetic retinopathy in James Bay，Ontario：a cost-effectiveness analysis［J］.Canadian Medical Association Journal，2003，168（2）：160-164.
［20］CORONADO A C，ZARIC G S，MARTIN J，et al.Diabetic retinopathy screening with pharmacy-based teleophthalmology in a semi urban setting a cost-effectiveness analysis［J］.CMAJ Open，2016，4（1）：e95-102.DOI：10.9778/cmajo.20150085.
［21］NGUYEN H V，TAN G S，TAPP R J，et al.Cost-effectiveness of a national telemedicine diabetic retinopathy screening program in Singapore［J］.Ophthalmology，2016，123（12）：2572-2580.DOI：10.1016/j.ophtha.2016.08.021.
［22］SHARMA S，HOLLANDS H，BROWN G C，et al.The cost-effectiveness of early vitrectomy for the treatment of vitreous hemorrhage in diabetic retinopathy［J］.Current Opinion in Ophthalmology，2001，12（3）：230-234.
［23］HABIB S H，BISWAS K B，AKTER S，et al.Cost-effectiveness analysis of medical intervention in patients with early detection of diabetic foot in a tertiary care hospital in Bangladesh［J］.Journal of Diabetes & Its Complications，2010，24（4）：259-264.DOI：10.1016/j.jdiacomp.2008.12.005.
［24］TENNVALL G R，APELQVIST J.Prevention of diabetes-related foot ulcers and amputations：a cost-utility analysis based on Markov model simulations［J］.Diabetologia，2001，44（11）：2077-2087.
［25］HABIB S H，AKTER S，SAHA S，et al.Cost-effectiveness analysis of medical intervention in patients with early detected of Diabetic Nephropathy in a tertiary care hospital in Bangladesh［J］.Diabetes & Metabolic Syndrome，2010，4（3）：123-127.DOI：10.1016/j.dsx.2010.07.008.
［26］HOERGER T J，HICKS K A，SORENSEN S W，et al.Cost-effectiveness of screening for pre-diabetes among overweight and obese U.S. adults［J］.Diabetes Care，2007，30（11）：2874-2879.
［27］GOZZOLI V，PALMER A J，BRANDT A，et al.Economic and clinical impact of alternative disease management strategies for secondary prevention in type 2 diabetes in the Swiss setting［J］.Swiss Medical Weekly，2001，131（21/22）：303-310.

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